Diabetes- Latest Update

Diabetes- Latest Update

•  28/10/2016: Ministry of Health and Family Welfare (MoHFW) in collaboration with the WHO Country Office for India and other partners, has launched a mobile health initiative for the prevention and care of diabetes – mDiabetes.
• mDiabetes will contribute to improving awareness about diabetes and promoting healthy diets and active lifestyle, which are vital to the prevention of diabetes.
• mDiabetes will also enhance health care seeking and early diagnosis, contribute to better adherence to drug or dietary control, self-care, as well as prevention of complications among patients with diabetes.
• Similar to the mCessation programme for tobacco cessation, individuals may register for mDiabetes by giving a missed call to 011-22901701. Alternatively, one may register online on the National Health Portal web site.
• The web site has a Diabetes Risk calculator based on the Indian Diabetes Risk Score (IDRS) developed by Dr. M V Mohan and colleagues in Chennai, among other useful information.
• The IDRS is a simple way to assess risk of developing diabetes among undiagnosed persons, and includes only four parameters- Age, Abdominal obesity, Family history of diabetes, and Physical activity.
• A follow-up study by Dr. Mohan and colleagues showed that the IDRS is more effective and less expensive than performing OGTT or genetic phenotyping on the entire population for the detection of diabetes.

BRADYCARDIA

Bradycardia

• Name the causes of bradycardia!

Physiological bradycardia is seen during sleep and in athletes.

In typhoid fever, yellow fever and brucellosis, we see relative bradycardia.

Pathological bradycardia is seen in hypothermia, hypothyroidism, raised intracranial tension

 & inferior wall myocardial infarction, hypertension, bradyarrhythmia, etc.

• What is relative bradycardia?

In fever, we would normally expect tachycardia. But despite the fever being there, here the rate

is not high, therefore, relative bradycardia.

For every degree rise in temperature, the pulse increases by 10 bpm. When there is fever and

the heart rate doesn't increase proportionately, it is termed relative bradycardia

• Why does obstructive jaundice causes bradycardia?

I thought it was because of the effect of raised bilirubin on the SA node. But I was wrong.

Sinus bradycardia is not a feature of obstructive jaundice and that high serum bile acid concentrations 

do not exert a slowing effect on the sino-atrial node.

IMMUNOLOGY MCQs

IMMUNITY

1. A doctor suggested to a couple not to have more than one child because of

(a) Rh+ male Rh- female

(b) Rh- male Rh+ female

(c) Rh+ male Rh+ female

(d) Rh- male Rh- female                

2. A noninfectious unnatural and unusual reaction to asubstance or condition is

(a) Immunity

(b) Allergy

(c) Infection

(d) Toxin

 3. A person is injected with gammaglobulin against hepatitis B. It is

(a) Artificially acquires passive immunity

(b) Artificially acquires active immunity

(c) Naturally acquires active immunity

(d) Naturally acquires passive immunity        

4. Acquired immunity as developed after vaccination or infection is found in

(a) Vertebrates only

(b) Invertebrates as wellas vertebrates

(c) Plants

(d) All the above

5. Active immunity means

(a) resistance developed before disease

(b) Resistance developed after disease

(c) Increased heart beat

(d) Increased flow of blood

6.Which is most abundant immunoglobulin

(a) Ig A

(b) Ig D

(c) Ig G

(d) Ig M

7. An example of innate immunity is

(a) T-lymphocytes

(b) B-lymphocyte

(c) Neutrophils

(d) Thyroid cells               

8.  An insect bite may result in inflammation of that spot. It is triggered by alarm chemicals such as

(a) Histamine and dopamine

(b) Histamine and kinins

(c) Interferon and opsonin

(d) Interferons and histones

9.Antibodies are formed by

(a) T-cells

(b) Monocytes

(c) Phagocytes

(d) B-cells

10.Antibodies are produced by

(a) Histiocytes

(b) Mast cells

(c) Plasma cells

(d) Fibroblasts

MCQs - HUMAN HEALTH AND DISEASES

HUMAN HEALTH AND DISEASES

Question 1

A certain patient is suspected to be suffering from Acquired Immune Deficiency Syndrome. Which diagnostic technique will you recommend for its detection?

A.WIDAL

B.ELISA

C.MRI

D.Ultra sound

Question 2

Common cold is not cured by antibiotics because it is-

A.Caused by a Gram-negative bacterium

B.Not an infectious disease

C.Caused by a virus

D.Caused by a Gram-positive bacterium

Question 3

Which of the following diseases is due to an allergic reaction?

A.Enteric fever

B.Hay fever

C.Skin cancer

D.Goitre

Question 4

Which of the following is a pair of viral diseases?

A.Typhoid, Tuberculosis

B.Ringworm, AIDS

C.Common Cold, AIDS

D.Dysentery, Common Cold

Question 5

Common cold differs from pneumonia in, that

A.Pneumonia is caused by a virus while the common cold is caused by the bacterium Haemophilus influenzae

B.Pneumonia pathogen infects alveoli whereas the common cold affects nose and respiratory passage but not the lungs

C.Pneumonia is a communicable disease whereas the common cold is a nutritional deficiency disease

D.Pneumonia can be prevented by a live attenuated bacterial vaccine whereas the common cold has no effective vaccine

Question 6

Cirrhosis of liver is caused by the chronic intake of

A.Tobacco (Chewing)

B.Cocaine

C.Opium

D.Alcohol

Question 7

Motile zygote of Plasmodium occurs in

A.Human RBCs

B.Human liver

C.Gut of female Anopheles

D.Salivary glands of Anopheles

Question 8

Swine Flu is caused by

A. HIV

B. HINI

C. Herpes zoster

D. Mumps virus

Question 9

Infection of Ascaris occurs due to ?

A.Contaminated food and water

B. Mosquito bite

C. Tse-tse fly

D.  Sand fly         

Question 10

Disease existing at or before birth is called?

A. Congenital

B. Communicable

C. Noncommunicable

D. None of these

ANSWERS

1. B. ELISA- Enzyme linked immunosorbent assay - used to detect HIV. It is not a confirmatory test, only screening test. Confirmatory test is Western Blot test.
WIDAL done for Typhoid.

MRI for soft tissues.

USG for visceral examination.

2. C. Common cold is a viral disease (rhinoviruses). Highly infectious. Viral diseases have no effect by antibiotics.

3. B. Hay fever- Allergic rhinitis (High levels of IgE)

4. C. common cold and AIDS

 Typhoid- Salmonella typhi (B) Tuberculosis - Mycobacterium tuberculosis   (B)

Ringworm - fungus Dysentry can be viral and bacterial.

5. B. NCERT statement

6. D. Alcohol- Liver cirrhosis is due to chronic alcohol intake.

7. C. Gut of female anophles. See the life cycle chart provided in WhatsApp Programme.

8. B. H1N1 strain of Orthomyxovirus 

H is for hemaglutinnin

N is for neuraminidase

9. A. Infection occurs by eating food or drink contaminated with Ascaris eggs from feces.

10. A. Congenital - By birth.

MALARIA

M1. Black water fever is a special manifestation of malaria caused by;

       a. P. falciparum
       b. P. malariae
       c. P. ovale
       d. P. vivax 

M2. After sporozoite gain entrance to human body it undergoes developmental cycle first in          liver than in RBC, only after which fever is seen. This incubation period varies between         plasmodium species, and ………….. species has longest incubation period.

       a. P. falciparum
       b. P. malariae
       c. P. ovale
       d. P. vivax

M3.For which one among the following diseases no vaccine is yet available?

      A. measles

      B. mumps

      C. tetanus 

      D. malaria

M4. Infective stage of Malaria is ?

      a. Sporozoites- round shaped

      b. Sporozoites - sickle shaped

      c. Sporozoites- Oval shaped

      d. Sporozoites- Discoid shaped.

M5. Which of the following is not a complication of Malaria?

      a. Cerebral infection

      b. Pneumonia

      c. Renal failure

      d. Anemia

M6. Relapse of Malaria is seen in infections with?

      a. P. vivax

      b. P. ovale 

      c. Both a and b

      d. All plasmodium species.

M7. Preparation of thin film in microscopic diagnosis of malaria is done for?

      a. Identifying the species of Plasmodium

      b. Counting the density of Plasmodium/cubic mm

      c. Watching the response of treatment

      d. Watching the severity of damage of RBCs

M8. World Malaria Day is celebrated on?

      a. 15th April 

      b. 15th May

      c. 25th April

      d. 25th May

M9. Introduction of which fish is used in Biological control of larvae of Plasmodium?

      a. Cichlid 

      b. Gambusia affinis

      c. Common carp

      d. Mahi-Mahi

M10. Under NVBDCP, chemical are sprayed in the larva-breeding sources to control malaria in how many days interval?

      a. Daily

      b. Monthly

      c. Yearly

      d. Weekly

ANSWERS

M1. A. P. Falciparum - causes recrudescence of malaria causing fever , damage to kidneys leading to haemoglobinuria- hence called black water fever.

M2. B. P. Malariae has longest incubation period.

M3. D. Malaria

M4. B. Sporozoites are sickle shaped- stored in salivary gland of anophles.

M5. B.Pneumonia is not a complication of malaria. Cerebral malaria, damage to RBCs , renal failure (Black water fever) is seen as complication of malaria.

M6. C. Both P. ovale and P. vivax can cause relapse through formation of hypnozoites.

M7. A. Identification of species is done through the thin film microscopy.

M8. C. 25th April

M9. B. Gambusia affinis-It feeds on mosquito larvae- used as biological control method of malaria.

GAMBUSIA AFFINIS

M10. D. Weekly- 6 diseases comes under NVBDCP (National Vector borne disease control programme) - MALARIA, JE, DENGUE, FILARIASIS, CHIKENGUNYA, KALAZAR. Weekly chemical larvicides are sprayed under this programme (Malathion, Temephos etc). 

Blood Group O-ve

O negative blood group

Review question time!

Q.Which is the universal donor?
And why?

A:- O negative. No antigens.

But it still has anti-A and and anti-B antibody...

Won't they react to the RBC present in the recipient?

Confused at the O negative thing. I Will explain it here.

The things is when you give blood to the recipient.

The plasma in the O- blood is rapidly mixed with the 5 litres 

of the recipients plasma.

So the antibodies are diluted. They are not effective in causing 

agglutination of the recipients RBC.

Why doesn't this happen with any other mis matched blood groups?

Cause in those cases the RBC's are having antigens.

So they are rapidly agglutinated.

Mismatched blood transfusions are due to agglutination of donors RBC, 

never the recipients RBC.

I HOPE THIS WAS HELPFUL...

Thanks

NISCHAY KIT Vs NIKSHAY

#WhatsApp Learning Program
#AIIMS_SPECIAL

#GK+BIOLOGY

Q. 'Nischay kit'  provided by Government of India to the ASHA under National Rural Health Mission is meant for?

A. Safe delivery at home

B. Rapid diagnostic kit for Malaria

C. Rapid sputum analysis for tuberculosis

D. Pregnancy testing kit.

#Use of Google prohibited.

ANSWER:- It was good when someone said "Sir !!! Only Google was prohibitted,I had options of Internet explorer, Opera mini and UC Browser.

• NISCHAY KIT- Pregnancy detection kit
• NIKSHAY- WEB BASED ONLINE TOOL FOR MONITORING TUBERCULOSIS
• I will make it simple for you all to remember- Nischay- means decision- Pregnancy kit. Nikshay- "shay" means 'infection'- TB
• I will make it simpler - niKshay- K for 'KITANU' means bacteria = TB
• I will make it simplest- Just remember "Akshay(Nikshay) Kumar can get TB but he can never get pregnant" 

Nishchay- A GOI Program Under NRHM MOHFW, Govt. of India:

Nishchay- A GOI Program Under NRHM MOHFW, Govt. of India Roll out by Hindustan Latex Family Planning Promotion Trust (HLFPPT)

• What is Nishchay? Identifies presence of Human Chorionic Gonadotropin (hCG) in urine Manufactured by Hindustan Latex Limited (HLL)
  
  

  Genesis:

  Genesis Govt. of India introduced “Nishchay – Home based pregnancy test card” across the country Nishchay is not a product but a program. Intends to link women to timely RCH and F.P. services.
  
  

  Genesis:

  Genesis Nishchay would be available to all eligible women FREE OF COST Kit will be made available through public health care system Rural women will get kit through ASHA/ANM in the village itself.
  
  

  Objective of the program:

  Objective of the program Early detection of pregnancy rather than waiting for physical symptoms to show up. Early registration of pregnant woman and early initiation of ante natal care. Enhanced decision making ability regarding continuation of pregnancy. Increased scope to avail Family Planning Services
  
  

  Rationale of the program:

  Rationale of the program To address the anxiety due to delayed or missed menstrual cycle and offer a simple home based test card through which she herself can detect her pregnancy status, rather than awaiting for physical symptoms to come up.
  
  

  What is hCG ?:

  What is hCG ? A glycoprotein hormone secreted by developing placenta shortly after implantation Can be identified 6-15 days after conception
  
  

  hcg (contd.):

  hcg (contd.) hCG is measured in milii-international units per mili- litre (mlU/ml) With Nishchay Pregnancy Test Card, hCG level above 25mlU/ml gives positive result
  
  

  hCG (contd.):

  hCG (contd.) Concentration of hCG increases to 50 mIu/ml one week post implantation Reaches around 100 mIu/ml at the time of first missed menstrual period Reaches peak at 1,00,000 to 2,00,000 mIu/ml at the end of first trimester
  
  

  hCG (contd.):

  hCG (contd.) Test utilizes combination of monoclonal and polyclonal antibodies reagents to selectively detect elevated hCG level in urine
  
  

  hCG (contd.):

  hCG (contd.) Immunological specificity of the test card virtually eliminates cross reactivity interferences from the structurally related glycoprotein hormones FSH, LH, TSH at physiological levels
  
  

  hCG (contd):

  hCG ( contd) Level of HCG should not be used to date a pregnancy.
  
  

  Key Issues:

  Key Issues Low percent of women starting ANC in first trimester due to late detection Contraceptive Provisioning (IUD/Pill) not started after ruling out pregnancy High unsafe abortions due to late detection
  
  

  NISCHAY:

  NISCHAY Access to “5 minutes pregnancy test kit” through ASHA and or PHCs and Sub- Centres An Entry Point for women to access Quality RCH & Family Planning Services. Outreach communication of “5 minutes pregnancy test”
• If a female urine is hCG positive , she is pregnant (good news)
• If a male urine is hCG positive, he is suffering from a testicular cancer/tumor (worst news)

PLAGUE

PLAGUE

• The GREAT DEATH/ MAHAMARI
•  Epidemics of plague, such as the ‘Black Death’, have attacked humans since ancient times, with a high fatality rate. 
• The causative organism, Yersinia pestis, is a small Gram-negative bacillus that is spread between rodents by their fleas, which may also bite humans.
• In the late stages of human plague, Y. pestis may be expectorated and spread between humans by droplets. The incubation period is 3–6 days, and three distinct forms are recognised. 
• Bubonic plague:- In this, the most common form of the disease, the onset is usually sudden with a rigor, high fever, dry skin and severe headache. Soon, aching and swelling at the site of the affected lymph nodes begin. The groin is the most common site of the ‘bubo’ (the swollen lymph nodes and surrounding tissue). A rapid pulse, hypotension, mental confusion and splenomegaly develop rapidly. 
• Septicaemic plague:- The patient is toxic and may have GI symptoms such as nausea, vomiting, abdominal pain and diarrhoea. DIC may occur, manifested by bleeding from various orifices or puncture sites, along with ecchymoses. Hypotension, shock, renal failure and ARDS may lead to further deterioration. Meningitis, pneumonia and expectoration of bloodstained sputum may complicate the picture. There is a high mortality. 
• Pneumonic plague: The onset is very sudden with cough and dyspnoea. The patient soon expectorates copious blood-stained, frothy, highly infective sputum, becomes cyanosed and dies. 
• X-rays of the lung show a lobar opacity.
•  Investigations • A high index of clinical suspicion is required. • An aspirate from a bubo, sputum or the buffy coat (leucocyte fraction) of blood is used to show the characteristic bipolar staining organisms by staining with methylene blue or by immunofluorescence. • Blood, sputum and aspirate should be cultured. • DNA diagnosis through PCR and rapid diagnostic tests (RDTs) has been developed to improve on the sensitivity of the existing methods. • Plague is a notifiable disease.
• Management • Streptomycin or gentamicin is the drug of choice. • Tetracycline and chloramphenicol are alternatives. • Treatment may also be needed for acute circulatory failure, DIC and hypoxia. • Those treating the patient should wear protective clothing, and inadvertent exposure should prompt prophylactic treatment with doxycycline.